In recognition of World AIDS Day, the O’Neill Institute is hosting a brown bag lunch discussion on innovative approaches to HIV treatment and prevention. The event will take place on Friday, November 30, 2018 from 12:00-1:30pm at the Georgetown University Law Center in McDonough Hall Room 200. It will include a discussion of the following three approaches: (1) molecular HIV surveillance, which is the collection and analysis of HIV genetic data to support health departments in identifying HIV transmissions patterns and in preventing new infections, (2) long-acting agents, which are products under development to treat and prevent HIV infection and would not require daily dosing, and (3) efforts to start people living with HIV on antiretroviral therapy (ART) on the same day that they receive an HIV diagnosis or are re-engaged in HIV care. I will lead this discussion and also give an introductory presentation.
First, the application of molecular HIV surveillance offers an exciting way to effectively identify and intervene in places where HIV transmission is occurring. Molecular HIV surveillance, however, raises critical and urgent questions around privacy and consumer protection. For example, it could potentially expose people to criminal prosecution or may be used by public health programs in ways that violate individuals’ privacy, such as when outreach workers engage in partner services efforts. Discussion will center on the promises and potential risks of using this emerging public health technology to prevent HIV infection. The Infectious Diseases Initiatives at the O’Neill Institute has previously convened a stakeholder consultation meeting in June 2018 on molecular HIV surveillance that brought to staff from the Centers from Disease Control and Prevention and state and local health departments, people living with HIV, HIV advocates, and others and, going forward, will work as part of a multidisciplinary team at Georgetown University to assess relevant legal and policy considerations when using this technology in public health surveillance and programming.
Second, important education and policy dialogues are needed to prepare for innovative long-acting products under development to treat and prevent HIV infection. Jeffrey Crowley and I have worked with amfAR to release four reports, Long-Acting HIV Treatment and Prevention Care Coming: Preparing for Potential Game Changers. The event will touch upon this work. Discussion will center on a range of policy issues such as: Food and Drug Administration (FDA) approval to questions about consumer and provider acceptance, drug pricing, and the payer landscape (Medicaid, Medicare, private insurance), with attention to the Trump Administration’s plan to reduce drug prices, including altering how Medicare’s Part B program pays for certain drugs and changing Medicare’s payment system to encourage doctors toward less expensive medications.
Third, one of the most significant approaches to make progress in HIV treatment and prevention is to treat HIV earlier by offering rapid start of ART (within days) when individuals receive an HIV diagnosis or are re-engaged in HIV care. Research studies show that rapid start is safe and shortens the time to viral suppression, but there are challenges to implementing and scaling up rapid start programs. At the event, we will discuss rapid start and how the Ryan White HIV/AIDS Program can be leveraged to overcome barriers to widespread adoption of rapid start.
The United States must continue investing in HIV treatment and prevention services. By investing in research and program innovation, it is possible to keep driving down the number of new HIV infections and to support all people living with HIV to live long and healthy lives.
More information about the World AIDS Day event and information about how to RSVP to attend the event can be found here. For the third year in a row, this event is open to members of the Georgetown University community and interested members of the public. Topics of past World AIDS Day events have included a call to action for ending prosecutions based on HIV status and a presentation on HIV criminalization and the opioid crisis.
The views reflected in this expert column are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.